Health Insurance Premium Payment (HIPP) Assistance
OA-HIPP is a subsidy program that pays monthly health, dental, and vision insurance premiums for eligible clients.
To be eligible for the OA-HIPP program, a client must:
- Be enrolled in ADAP
- Have an HIV/AIDS diagnosis
- Be a California resident
- Be at least 18 years old
- Have a Modified Adjusted Gross Income (MAGI) that does not exceed 500% Federal Poverty Level based on household size (Effective June 24, 2015)
- Not be enrolled in Medicare or Full-Scope (Free) Medi-Cal or Medi-Cal Expansion
How to Apply
Clients have two options:
1. Contact an ADAP enrollment worker. An enrollment worker can help clients with:
- Faxing the required supporting documentation to ADAP, and
- Indicating in the ADAP Enrollment System that the client would like health insurance premium assistance.
Please use the ADAP Enrollment Site List (Excel) to find a local ADAP certified enrollment site.
2. Enroll directly with OA. If clients cannot reach an enrollment worker or would prefer to enroll directly with OA, they can:
- Complete sections 1 (Profile) and 6 (Insurance) of the ADAP application (PDF)
- Sign and date page 9 of the application
- Sign and date the ADAP Consent Form (pages 10-11)
- Submit the completed ADAP application sections and health plan billing statement or California Enrollment Summary to ADAP.
Clients can submit completed forms with original signatures and documentation directly to OA using the following methods:
- Fax: (844) 421-8008 using the ADAP Fax Coversheet (PDF)
- Mail: Insurance Assistance Section, California Department of Public Health, P.O. Box 997426, MS 7704, Sacramento, CA 95899-7426
If clients or enrollment workers are having difficulty accessing enrollment materials or need additional assistance, they should contact the ADAP call center (844) 421–7050.
Once a client is enrolled in the OA-HIPP program they will be responsible for informing their enrollment worker or ADAP of any changes to their insurance policy. A good rule of thumb is to update the OA-HIPP information any time the client is updating their ADAP information. Mirroring ADAP requirements, clients need to re-enroll in the OA-HIPP program before their birthday month every year by submitting all of the required documents.
Six months after their birth month, clients are required to recertify with our program by submitting:
- A signed client attestation form,
- Confidential Fax Cover sheet, and
- The most recent insurance billing statement from the health insurance plan with the following information:
- current premium rate (including Advanced Premium Tax Credit if applicant is a Covered California member),
- client subscriber or billing ID,
- policyholder's name and billing address, and
- where payments should be mailed
Covered California Clients:
If a client received OA-HIPP assistance in the previous tax year, they must submit their most recent signed and dated federal tax return as well as IRS form 8962 (or IRS form 4868 for a tax extension) on their first recertification or reenrollment after April 15th. For more information about this requirement please contact the ADAP call center at (844) 421-7050.
Dental and Vision Plans:
Dental plans can be covered only if a client is already enrolled in OA-HIPP for a health insurance plan.
Vision insurance can also be paid but only if included as part of a combined health or dental plan.
OA-HIPP clients can remain on the program as long as the services are needed and they continue to meet all the program requirements.
Prospective OA-HIPP clients should expect to pay their monthly insurance premiums until it has been confirmed that their application has been approved and payment has been submitted to the health plan. New, complete applications will be processed within six weeks of receipt.
For a full description of a client's responsibilities while enrolled in OA-HIPP please see our client responsibilities form (PDF).